Anti-protozoal drugs

Question 1

what are 5 chemoprophylaxis options for Malaria

Answer 1

1. Chloroquine
   
   • drug reistanct in P.falciparum due to overuse, Worldwide, not recommended in most areas
2. Atovaquone and proguanil
   
   • Malrone
   • good for last minute trips, contraindictaed in pregancy
3. Doxycycline
   
   • cheapst antimalarial
   • side effects- photosensitivty, GI upsets, not safe in pregnancy
4. Mefloquine
   
   • longer trips, taken weeky, safe in pregnancy
   • side effects- nightwares/vivid dreams, halluicnation , MH
5. primaquine
   
   • goof forprvent P.vivax malrai
   • destory hypnozoites
   • contraindicated- G6Pd deficient patient- trigger haemolyitc anaemia

Question 2

which chemoprophylaxis is best for pregnancy

Answer 2

mefloquine

but has side efefcts- nightmares, halluicnatiin and wrosenign. MH

Question 3

What are the Treatment options for Malaria

Answer 3

• Artesunate/ Artemisinin
  
  • IV artesunate first line for severe malaria
  • rarely used in monotherapy- combined with another drug in ACT
  • mechanims not fully understood
• choloroquine
• atovaquone
  
  • inhbit synthesis of pyrimdiine
• Proguanil
  
  • inhbits dihyrodfolate reductase- parasite unable to recyel folate
  • usually in conjuction with other AM, resistance ofbserrved
• Primaquine
  
  • inhbits repsiration, used for dormant hypnozoites in P.vivax/ovale
  • side effects0 anorexia, nausa, vommtiing, cramops etc over dosage granuloctyotpenai

Question 4

what is the treatment of amoebiasis

Answer 4

oral metronidazole ( targets DNa synthesis ) to treat invasice amoebiasis)

luminal amoebicide to eradicate gastrointestinal cysts

Question 5

treatment of giardiasis

Answer 5

oral metronidaizole ( interfers with DNa synthesis

Question 6

treatment for cytopsoridiosis

Answer 6

manage symtposm with rola rehydration /iv fluids

immunocomprpomsued patietns may need - Nitazoxanide (antiparasisitic)

Question 7

how is American trypanososmiaiss treated?

Answer 7

Benznidazole

very effective in early diseas-e less efect in diseas- generates radical specieis which damages the parasites DNa

Question 8

African Trypanosomiaiss

Answer 8

Treatment complex and depends on the specieis and clincial satge

one drug

Melarsoprol- arsenic derative- highyl toxic death in 8%

Question 9

Treatment for Leishmaniais

Answer 9

Sodium stibogluconate- reduces ATP availabel for parasite

Amphotercin B- acts on ergosterol to dsirupt the parasite cell memrbane and cause cell deeath (not this is alose an antifugnal but both fungi and leishmanai ahev ergosterol in the cell membrane